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CC BY-NC-ND 4.0 · Rev Bras Ginecol Obstet 2017; 39(08): 403-407
DOI: 10.1055/s-0037-1603965
Original Article
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Evaluation of Cases of Abdominal Wall Endometriosis at Universidade Estadual de Campinas in a period of 10 Years

Avaliação dos casos de endometriose de parede abdominal na Universidade Estadual de Campinas em um período de 10 anos
Daniela Angerame Yela
1   Department of Obstetrics and Gynecology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, Brazil
,
Lucas Trigo
1   Department of Obstetrics and Gynecology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, Brazil
,
Cristina Laguna Benetti-Pinto
1   Department of Obstetrics and Gynecology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, Brazil
› Author Affiliations
Further Information

Publication History

21 January 2017

03 April 2017

Publication Date:
21 June 2017 (online)

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Abstract

Purpose To determine the clinical and epidemiological characteristics of abdominal wall endometriosis (AWE), as well as the rate and recurrence factors for the disease.

Methods A retrospective study of 52 women with AWE was performed at Universidade Estadual de Campinas from 2004 to 2014. Of the 231 surgeries performed for the diagnosis of endometriosis, 52 women were found to have abdominal wall endometriosis (AWE). The frequencies, means and standard deviations of the clinical characteristics of these women were calculated, as well as the recurrence rate of AWE. To determine the risk factors for disease recurrence, Fisher's exact test was used.

Results The mean age of the patients was 30.71 ± 5.91 years. The main clinical manifestations were pain (98%) and sensation of a mass (36.5%). We observed that 94% of these women had undergone at least 1 cesarean section, and 73% had used medication for the postoperative control of endometriosis. The lesion was most commonly located in the cesarean section scar (65%). The recurrence rate of the disease was of 26.9%. All 14 women who had relapsed had surgical margins compromised in the previous surgery. There was no correlation between recurrent AWE and a previous cesarean section (p = 0.18), previous laparotomy (p = 0.11), previous laparoscopy (p = 0.12) and postoperative hormone therapy (p = 0.51).

Conclusion Women with previous cesarean sections with local pain or lumps should be investigated for AWE. The recurrence of AWE is high, especially when the first surgery is not appropriate and leaves compromised surgical margins.

Resumo

Objetivos Determinar as características clínicas e epidemiológicas da endometriose de parede, bem como sua taxa de recorrência e os fatores que levam a ela.

Métodos Estudo retrospectivo, em que se avaliaram 52 mulheres com endometriose de parede na Universidade Estadual de Campinas no período de 2004 a 2014. Entre as 231 cirurgias para diagnosticar endometriose, foram encontradas 52 mulheres que apresentavam endometriose de parede. Foram calculadas as frequências, a média e o desvio padrão das características clínicas destas mulheres, bem como a taxa de recorrência da endometriose de parede. Para determinar os fatores de risco de recorrência, foi utilizado o teste exato de Fisher.

Resultados A idade média das mulheres foi de 30.71 ± 5,91 anos. As principais manifestações clínicas foram dor (98%) e sensação do nódulo (36,5%). Foi observado que 94% dessas mulheres tinham pelo menos uma cesárea, e 73% destas fizeram uso de medicação para controle da endometriose no pós-operatório. A localização mais frequente da lesão foi na cicatriz da cesárea (65%). A taxa de recorrência da doença foi de 26,9%. Todas as 14 mulheres que tiveram recidiva tinham margens cirúrgicas comprometidas na cirurgia prévia. Não houve correlação entre a endometriose de parede recorrente e a cesariana prévia (p = 0,18), a laparotomia prévia (p = 0,11), a laparoscopia prévia (p = 0,12) e receber terapia hormonal no pós-operatório (p = 0,51).

Conclusão Mulheres com antecedente de cesárea anterior com dor local ou nódulo devem ser investigadas com relação à endometriose de parede. A recorrência do endometrioma de parede é alta, principalmente quando a primeira cirurgia não é adequada, e deixa margens cirúrgicas comprometidas.

Keywords

abdominal wall endometriosis - pelvic pain - recurrence - cesarean section scar

Palavras-chave

endometriose de parede - dor pélvica - recorrência - cicatriz de cesárea
 

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